- OrthopedicsGeneral Page Tier 3BlogIf you’re a long-distance runner, you know the importance of fueling up before you hit the streets or your favorite running trail. What you should eat and drink to maximize your performance, though, is a mystery for many runners. Should you load up on carbohydrates? Go heavy on the protein? Down sports drinks? Here’s what runners should consider as they train. Carbohydrates and running The National Academy of Sports Medicine (ASCM) says athletes may have up to 40 percent greater energy needs than non-athletes. That means if you’re not eating the right foods, your performance could suffer. Carbohydrates are an important part of any runner’s nutrition plan. Carbs are stored in your muscles as glycogen, which serves as long-term energy storage. Your body relies on glycogen when you exercise, and it’s important to keep your glycogen stores full so you don’t crash during a tough workout. Eat before you work out, even if you don’t feel hungry, says The American College of Sports Medicine. About three to four hours before your workout, eat a meal of 300-600 calories that contains mostly carbohydrates, a moderate amount of protein, and a low amount of fat. Examples include toast with peanut butter, or a turkey sandwich with fruit. The ACSM says endurance athletes, such as distance runners, should refuel every 45 to 60 minutes during a long workout, taking in 30 to 60 grams of carbohydrates (or 120-240 calories) each hour. For shorter races or runs, it is not necessary to consume food during the race, but post-run replenishment is most efficient immediately after exercise. Good foods to eat during a long exercise session include energy gels or beans, honey, bananas or oranges. Eat your protein Remember the importance of protein. It is the building block of your cells, and it’s especially important during the recovery process. Running and training breaks down cells. As you recover, those cells are repaired to make you better, faster and stronger — as long as the right ingredients, including protein, are available. The ACSM recommends eating a post-workout snack of 300 to 400 calories containing a mix of carbs and protein. The carb-to-protein ratio should be 2:1 in short, low- to medium-intensity workouts, or 3:1 in long, high-intensity workouts. Opt for low-fat, high-protein sources, such as beans, fish and poultry. Milk-based protein, like chocolate milk, is thought to be one of the best sources of protein post-workout. Fats aren’t all bad Fats, like carbs, provide energy. Healthy fats, such as polyunsaturated fats and monounsaturated fats, are part of a balanced diet. They should be at least 20 percent of your total fat intake, according to the ACSM. Avocados are a good source, as well as nuts, olive oil, and salmon. Steer clear of saturated and trans fats, which can raise your cholesterol and lead to heart disease. A few special micronutrients: Iron, vitamin D, and calcium Long-distance runners are at high risk of iron-deficiency anemia. Low iron can result in decreased performance and a general feeling of tiredness. Your level of ferritin, a protein that stores iron, can determine if you need to take supplements. There is some debate over what is considered low, though 35 nanograms per millileter is often used as a minimum benchmark. You should talk to your doctor about the appropriate screenings for this. Adding iron-rich foods, like beef, can help. Turkey, chicken and some fish also have lesser amounts of iron, which your body can best absorb alongside foods rich in vitamin C. Vitamin D is crucial for bone health. Research has connected it to muscle strength, inflammation, and many other functions. Unfortunately, it is hard to get enough vitamin D, especially if you are wearing your sunscreen to protect your skin from the sun’s harmful rays. You can get your vitamin D level tested with a blood draw to determine if you need a supplement. Many doctors recommend taking 1,000 international units (IU) of vitamin D as a general rule. Calcium is also an important ingredient for not only strong bones, but also muscle and nerve health. Getting 1,000 to 1,500 milligrams of calcium from food each day is best. Hydration is important Making sure you are drinking enough water is important for everyone, but it’s especially important for runners. Research shows that dehydration, even if it’s mild to moderate, can decrease performance. There is some debate about whether you should use thirst as an indicator to drink, or if you should drink water before thirst sets in. Current recommendations are to bring water along with you on runs that are longer than an hour, or longer than a 10K. The ACSM suggests drinking two to four ounces every 15 to 20 minutes. It is possible to drink too much water during a long race, such as a marathon. In serious cases, you could develop hyponatremia, when your body has too much water and the level of sodium in the blood is too low. For long runs, consider a sports drink. Not only do they give you an extra boost of carbohydrates, they also replace sodium that you lose while sweating. They are also a good choice for hydrating after a run longer than 60-90 minutes. One last bit of advice: Don’t try any new foods or drinks on race day. You never know how your body might react, and that could be the difference between a great race and a bad one. By choosing the right foods and making sure you are staying properly hydrated — both during training and on race day — you can have your best race ever. Author Christina Morganti, MD, is an orthopedic surgeon at Anne Arundel Medical Center and avid long-distance runner. Dr. Morganti ran cross country and track at Brown University, and continues to compete in road races herself and run around cheering on her kids in their races. She has run numerous marathons, including New York, Boston, and the Marine Corps Marathon. You can reach her practice, AAMC Orthopedics, at 410-268-8862. Originally published Nov. 14, 2017. Last updated May 31, 2019.
- Orthopedics, WellnessGeneral Page Tier 3BlogI’m often asked for advice in choosing which shoes would be best for running fast, far and without injury. This is a difficult question to answer because so many variables are involved: your running goal, your history of injury, the type of running surface and other factors. These general guidelines are a great starting point for choosing the right running shoes: The shoes should feel comfortable in the store. Don’t expect you’ll be able to “break in” the shoes later. Your heel should not slip out of the shoes. Your toes should not hit the front of the shoes. The shoes should fit your arch type and foot mechanics. Ask for help, if needed. The shoes should be light and flexible, but also with a slight degree of stiffness for support and durability. Most running shoe stores organize the shoes in broad categories, including cushion, lightweight cushion, forefront cushion, motion control and neutral. In recent years another category—minimalist shoes—has developed. Here’s what you should know about each category of running shoes. Cushion Provides heel-to-toe comfort Best for heavier runners Tends to be heavier Good for runners with joint degeneration Lightweight cushion Has thick soles made of lighter weight material Newer technology, offers less “feel” for the road but more cushion without the weight Forefoot cushion Has less cushion in the heel relative to the forefoot, which is the opposite of traditional shoes Design encourages a foot strike pattern more on the midfoot than the heel Adapt to your new gait pattern carefully and gradually Motion control Specially designed with performance elements for stability Best for runners with excessive motion in the hind foot Neutral Good for runners without serious biomechanical issues or for use with orthotics Less expensive and lighter than other options Minimalist Lighter weight, less heel cushion Adapt to these shoes carefully and gradually to avoid injury I recommend trying on multiple pairs and going with what feels good after walking around the store. Many stores have a treadmill so you can try running in the shoes. Some even allow video analysis to check for stability. Even after giving shoe selection a lot of thought and research, there’s often an element of trial and error involved. These guidelines can get you running in the right direction to make your selection. Quick Running Tips Choosing a place: Avoid hard or rough road surfaces. An ideal running surface is flat, smooth, resilient and soft. Avoid crowded roads and run against traffic. Stay in well-lit areas, including schools and public streets. Choosing a time: Running during daylight is preferable. Avoid running if temperatures are above 90 degrees and humidity is high. Safety tips: Carry a cell phone with you. Avoid using headphones if you’re running on the street. Author Christina Morganti, MD, is an orthopedic surgeon at Anne Arundel Medical Center and avid long-distance runner. Dr. Morganti ran cross country and track at Brown University, and continues to compete in road races herself and run around cheering on her kids in their races. She has run numerous marathons, including New York, Boston, and the Marine Corps Marathon. You can reach her practice, AAMC Orthopedics at 410-268-8862. Originally published June 15, 2016. Last updated May 31, 2019.
- Women's HealthGeneral Page Tier 3BlogSummer means freedom from your socks and shoes, but what happens when your feet don’t look “sandal ready?” It may be that you have athlete’s foot or toenail fungus. These infections commonly follow the cooler seasons due to the lack of air circulation in socks and boots. Signs of an infection may include cracking of the skin, redness, itching, burning and discoloring of the toenails. If you think you have a fungal or bacterial infection, make an appointment to see your primary care provider or dermatologist because often these infections don’t go away on their own. It’s important to identify what the cause is, because there are a variety of diseases, including melanoma, that can cause changes in the toenails. Your doctor can recommend strategies such as over-the-counter antifungal creams, prescription drugs or other remedies. Not seeking treatment may allow the infection to spread to other parts of your body, like the hands and groin. Practicing good foot hygiene is crucial for the treatment and prevention of any foot or toe infection. This includes keeping your feet clean and dry on a daily basis. Always wear flip-flops or shower shoes in a moist environment, and especially avoid being barefoot in public areas, such as locker rooms, public pools and showers. Try an At-Home Pedicure Step 1: Soak feet in lukewarm water. This softens up your nails, as well as calluses and dead skin. Step 2: Scrub feet to exfoliate and remove dead skin cells. Step 3: Use a pumice stone or foot file to smooth out calluses. Step 4: Cut your toenails with sanitized nail scissors or clippers, making sure to cut them straight across. Avoid cutting them too short. Gently using a nail file on any sharp edges is fine. Step 5: Apply cuticle oil. The cuticles help keep germs away from your skin and nails. Step 6: Massage feet with a rich moisturizing lotion. Step 7: Add polish if desired, but apply a base coat to prevent the yellowing of nails and to extend the polish’s wear. Originally published Aug. 9, 2016. Last updated May 31, 2019.
- Men's Health, News & Press Releases, Orthopedics, Physical Therapy, Senior Care, Women's HealthGeneral Page Tier 3BlogIn celebrating the opening of AAMC Pavilion – Easton, we caught up with three Eastern Shore patients – Mettah, Yvette and Bob – who have traveled over the Chesapeake Bay Bridge for Anne Arundel Medical Center services. With our recent growth into Easton in Talbot County, these residents are now able to receive the same quality care closer to home. Read their stories to learn about how our service expansion can positively impact those you love, too, just as it has for Mettah, Yvette and Bob. Mettah Kollman, patient of AAMC’s Women’s Center for Pelvic Health and AAMC Orthopedics Mettah KollmanPatient of AAMC’s Women’s Center for Pelvic Health and AAMC Orthopedics ► Visit their new Easton locations today After retiring from her career as a human resources specialist for the federal government in 2004, Mettah Kollman and her husband moved from Laurel, Md., to the Eastern Shore. Mettah describes herself as a “frequent flyer” at Anne Arundel Medical Center (AAMC). To date, she’s had three knee replacements, a hip replacement, spine surgery, and most recently, pelvic floor reconstruction. “For the nine months prior to pelvic surgery, I had continuous urinary tract infections (UTIs),” Mettah said. “I was dependent upon the various kinds of sanitary products designed for bladder leakage.” This discomfort took its toll on 71-year-old Mettah, and she decided to get help. Mettah can now enjoy her retirement and continue her interests without pain. Currently, she serves as a Court Appointed Special Advocate (CASA) to aid children who come into the court system due to parental neglect or abuse. She is also active in the Easton branch of the American Association of University Women, dotes on her three grandsons, enjoys a book club and plays bridge regularly. Though Mettah hopes to avoid the need for further treatment, she feels comforted by the fact that AAMC specialists are no longer as far away and, instead, located nearby at the new AAMC Pavilion in Easton. READ MORE: AAMC Women’s Center for Pelvic Health recognized as leaders in women’s health care Yvette Foster Brown, patient of AAMC’s Rebecca Fortney Breast Center and Anne Arundel Diagnostic Imaging Yvette Foster Brown Patient of AAMC’s Rebecca Fortney Breast Center and Anne Arundel Diagnostic Imaging ► Visit its new Easton location today Yvette’s breast cancer journey began when she was in her mid-20s. “My mother, who was only 43, died from breast cancer in 1986.” Nearly 40 years later, Yvette found herself in the same position. After a routine mammogram at Anne Arundel Diagnostic Imaging (AADI), the imaging specialist referred her to the Rebecca Fortney Breast Center at AAMC in October 2017. Yvette met with breast surgeon Dr. Lorraine Tafra and attended several consultations before undergoing a breast biopsy in November. “When I received the phone call from the breast surgeon to inform me of the biopsy results, I was devastated. My biopsy came back positive for cancer,” she recalled. At the age of 55, separated and living by herself, she was diagnosed with ductal carcinoma in situ (DCIS) stage 3A breast cancer in January 2018. A breast cancer nurse navigator aided Yvette as she began her journey. “She was very supportive. She made all my required lab and imaging appointments, discussed surgical options, and reviewed my treatment plan with me.” In January 2018, Yvette had a mastectomy and d-flap breast reconstruction surgery. “My four-day hospital stay was very pleasant. The nursing staff and nursing assistants were so nurturing. Since I live by myself, I had never been pampered so caringly and efficiently the way the hospital staff did. Even the hospital meals were delicious.” In March, after recovering for several weeks, Yvette began her 15 months of chemotherapy. “I was able to tour the AAMC Outpatient Infusion Therapy Center where I would receive my chemo treatments. The nursing staff at the infusion center are so nurturing and knowledgeable,” she said. “They make sure the infusion patients are comfortable while receiving their medications. They offer patients drinks, snacks, and blankets as well as lunch.” Yvette reached out to a local breast cancer survivor group for support and advice. “Some women get their hair shaven off as a way of having some power or control over the chemo. Taking that advice, I went to a local hair salon and had my beautiful shoulder-length sister locks cutoff and scalp shaved bald,” she said. “I didn’t like looking in the mirror much after that. I purchased several wigs and I wore them even though they were uncomfortable.” The treatment was agonizing both physically and mentally. There were times when Yvette admitted she wanted to give up, but stayed strong with the loving support from her daughter as her motivation. “She drove me to and from my appointments, did my grocery shopping, laundry, and cleaning for the first few months. Due to the loss of appetite during the early phases of the chemo, my weight decreased rapidly.” In September, Yvette began six weeks of daily radiation treatments under the direction of Dr. Luqman Dad. “Having gone through my breast cancer journey in 2018 has made me a much stronger woman. I always considered myself confident, healthy, and independent, but never have I had to battle a life-challenging disease before and it was particularly scary knowing I would go through it alone,” she said. “I came through this journey with a newfound outlook on life and self-determination I didn’t know I had.” Yvette completes her chemotherapy plan this May. Her fight continues with the daily dose of Tamoxifen for the next five years. “My breast cancer journey has made me a more confident woman and I have a much greater appreciation for my relationships with family, friends and work colleagues. I am so blessed and so grateful to the wonderful doctors, nurses, and assistants at AAMC. The staff are so nurturing and pleasant, which has made my breast cancer journey such a positive experience. Thank you, AAMC!” William (Bob) Nelson, patient of AAMG Physical Therapy and AAMC Orthopedics William (Bob) Nelson Patient of AAMG Physical Therapy and AAMC Orthopedics ► Visit their new Easton locations today Kent Island resident and construction worker William (Bob) Nelson began April of 2018 just like any other month. Bob rode his motorcycle when the weather was nice, played the bass guitar with his band, and enjoyed spending time with his soon-to-be wife. On April 11, this all changed when he injured himself on the job. “I went to the doctor’s office and they initially said it was a sprain and had me start physical therapy elsewhere.” After two months, Bob’s knee was not improving. He was still working, and each day was a struggle. He received an X-ray and, upon review, the specialist determined surgery, in addition to physical therapy, might be the answer. His in-laws recommended Sports Medicine Specialist Dr. Benjamin Petre at Anne Arundel Medical Center (AAMC). “Since this was a workers’ compensation claim, I was able to choose my own doctor. I brought my MRI results to Dr. Petre and we set up a plan to start with physical therapy and a cortisone shot.” Throughout the rest of the summer, Bob continued physical therapy twice a week. In September, he had surgery. Bob was unable to bear any weight for the first six weeks while recovering, then only 50 percent of his body weight for two more weeks. Afterwards, he returned to physical therapy and finished his series of visits at the end of February. “My physical therapy was flawless from beginning to end. The equipment was up-to-date. The therapists were all knowledgeable and friendly. While I’m hoping I never have to go back for physical therapy, I would be quite happy to run into any of these people in the street and buy them a drink.” The last week of March, Bob began regular duty again and is back out in the field. “While my knee is not entirely back to normal, as Dr. Petre said it would take almost a year, its better every day, and I’m able to get back to the job – and activities – I love.”
- Pediatrics, WellnessGeneral Page Tier 3BlogSweet summertime — kids look forward to it all year long. For many children, summer means sleeping in, no homework and a break from scheduled activities. But for parents, summer may require more work and creativity than usual to keep kids active, off the couch and away from electronic devices and video games. Encouraging regular physical activity is one of the best things you can do for your child’s health. Aim for about 60 minutes of physical activity each day to keep children healthy. It’s important to note that this doesn’t require playing sports or traditional forms of exercise. Any way to get kids moving will do, like hopscotch, jumping rope or rollerblading — the sky’s the limit! The most important thing is to make it fun. Here are some simple tips to keep your kids active this summer: Frame activity as a reward. Using physical activity as a reward can make all the difference in how your children think about being active. If you give your kids chores or other tasks to do, let them pick between a swim at the pool, bike ride or trip to the park after they finish. Join them. Being active together as a family will teach kids healthy habits at a young age. Children learn by example and if they see you enjoying physical activity, they’re more likely to enjoy it as well. You can keep it simple with a walk around the block, shooting hoops in your driveway or at a local park, or a weekend hiking trip. Avoid the heat. To help prevent fatigue, try to avoid the hottest hours of the day (typically 11am to 4pm) for the most rigorous activities. Late morning and early evening are great times to get outside. Swimming is a great option for hot afternoons, just don’t forget the SPF! Reveal the wonders of the outdoors. A healthy dose of fresh air and sunlight is good for your health. Same goes for your kids. There are many beautiful sights to see and discover as a child, but your kids may need you to show them the wonders of the outdoors. If your children are prone to staying inside, take them to a local park or hiking trail and let them explore. You may even want to plan a weekend hiking or camping trip with the whole family. Use community resources. There are likely plenty of opportunities to keep kids active right around you, but it may require a little research. Get online to check out local cooking classes, camps, sports leagues, community pools, parks and more. Park trails are great for walks and bike rides! It’s not all up to you to come up with new experiences for your children. See what’s out there and try something new. Make it educational. Try visiting a museum or science center. Pick something that interests your child and offers interactive components to keep them engaged. They won’t even realize they’ve been on their feet moving around the whole time. Plus, it’s a great way to escape the heat for a day. Author By Michelle Skinner, DO, primary care doctor at Waugh Chapel Family Medicine. To reach her practice, call 410-721-1507. Originally published July 18, 2016. Last updated May 28, 2019.
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